Healthcare Hygiene magazine March 2020 | Page 25

Setting: 576-bed hospital | 27 ORs | 23,000 surgeries per year Benefits Hospital Challenges Solutions Metric Clinical High-touch objects cleaned just 20% of time for between-case cleaning Standardized the cleaning process across OR teams to address cleaning thoroughness and efficiency concerns High-touch object cleaning improved 66% Operational Poor communication, low job morale and high staff turnover among OR aides Environmental Monitoring tools for real-time and direct environmental hygiene monitoring and thoroughness of cleaning reporting Staff retention increased to 86%- 100%, and absenteeism decreased No method for determining thoroughness of cleaning OR turnover time decreased by an Surgical room turnover kits with disposable linens, microfiber average of 21 minutes cloths and mops to increase room turnover efficiency and cleaning effectiveness Point-of-use cleaning carts and tools to streamline the cleaning process and ensure compliance with best practices Financial Between-case process and turnover times inconsistent and high cost On-site best practices training on between-case and terminal Achieved $800 cost savings/room cleaning for all staff Facility potential savings per 1,000 savings per procedures of $800,000 + 167 hours Part of any continuous improvement process includes collecting and sharing data on metrics for success. In the case of improving between-case cleaning and disinfection, these metrics are turnover time and thoroughness of cleaning. Environmental monitoring programs that provide customizable, easy-to-read dashboards are helpful because they collate data points in one place, providing visibility to all stakeholders whenever they need it. However, not all dashboards are created equally, so it’s important to find one that meets your specific needs. For OR between-case cleaning, it can be especially helpful to be able to measure compliance and pinpoint precisely where corrective action is needed, down to a department, team or individual level. These actionable insights allow department managers, clinicians, EVS staff and other authorized users to lead process improvements where and when they are needed most to standardize workflows and keep patients safe. To summarize, successful surgical procedures are the highest priority in the surgical services department but taking a closer look at OR between-case cleaning can provide hospitals with additional value. There are clinical, operational and financial benefits to improving the efficacy and efficiency of between-case cleaning and disinfection that your hospital can begin to realize today. Here are five ways to improve your OR between-case cleaning: — Define roles and responsibilities clearly — Have efficient and effective between-case cleaning and disinfection supplies available — Train on best practices for cleaning and disinfecting an operating room — Objectively monitor the thoroughness of cleaning — Have access to actionable data on thoroughness of cleaning and room turnover time — Share data with staff to drive continuous improvement  www.healthcarehygienemagazine.com • march 2020 Linda Homan, RN, BSN, CIC, is senior manager of clinical affairs for Ecolab Healthcare. References: 1. Umscheid CA, Mitchell MD, Doshi JA et al. Estimating the proportion of healthcare -associated infections that are reasonable preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32:101-114. 2. Shepard J, Ward, W, Milstone Aaron, Carlson T, et al. Financial Impact of Surgical Site Infections on Hospitals: The Hospital Management Perspective. JAMA Surg. 2013;148(10):907-914. 3. Thompson KM, Oldenburg WA, Deschamps C et al. Chasing zero: The drive to eliminate surgical site infections. Ann Surg 2011:254:430-436. 4. Leas BF, Sullivan N, Han JH, Pegues DA, Kaczmarek JL, Umscheid CA. Environmental Cleaning for the Prevention of Healthcare-Associated Infections. Technical Brief No. 22 (Prepared by the ECRI Institute – Penn Medicine Evidence-based Practice Center under Contract No. 290-2012-00011-I.) AHRQ Publication No. 15-EHC020-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2015. www.effectivehealthcare.ahrq.gov/reports/final/cfm. 5. Yezli S, Barbut F and Otter JA. Surface contamination in operating rooms: A risk for transmission of pathogens? Surg Infect (Larchmt). 2014 Dec;15(6):694-9. 6. Jefferson J, Whelan R, Dick B, Carling P. A novel technique for identifying opportunities to improve environmental hygiene in the operating room. AORN J 93 (March 2011) 358-364. 7. Munoz-Price SL, Birnbach DJ, Lubarsky DA et al. Decreasing operating room environmental pathogen contamination through improved cleaning practice. Infect Control Hosp Epidemiol. 2012;33(9). 8. Ecolab data on file. 9. Ecolab data on file. 10. Ecolab data on file. 11. Han JH, Sullivan N, Leas BF, et al. Cleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections: A Technical Brief. Ann Intern Med. 2015;163:598–607. 12. Centers for Disease Prevention and Control, Options for Evaluating Environmental Cleaning. https://www.cdc.gov/hai/toolkits/evaluating-envi- ronmental-cleaning.html 13.Marcario A. What does one minute of operating room time cost? Journal of Clinical Anesthesia (2010) 22, 233–236. 14. Mitchell BG et al. An environmental cleaning bundle and health-care-as- sociated infections in hospitals (REACH): a multicentre, randomised trial. Lancet Infect Dis. 2019 Apr;19(4):410-418. 15. Kramer M and Kriznik S. The impact of an OR environmental hygiene program on OR culture and cleanliness. OR Manager Conference; Las Vegas, Nev.; Oct. 21-23, 2016. 25